What is the Difference Between Acute and Chronic Otitis Media

Acute and chronic otitis media are two different types of otitis media, an infection of the middle. It can be caused by cold, sore throat, respiratory infection, or trapped fluid. Otitis media is more common in children.

The key difference between acute and chronic otitis media is their cause. Acute otitis media is caused by a bacteria or virus while chronic otitis media is caused by fluid trapped behind the eardrum for more than three months. 

CONTENTS

1. Overview and Key Difference
2. What is Acute Otitis Media
3. What is Chronic Otitis Media
4. Similarities – Acute and Chronic Otitis Media
5. Acute vs Chronic Otitis Media in Tabular Form
6. Summary – Acute vs Chronic Otitis Media
7. FAQ – Acute and Chronic Otitis Media

What is Acute Otitis Media?

Acute otitis media is caused by a bacteria or virus. The most common bacterial pathogens in acute otitis media are Streptococcus pneumoniae, non-typeable Haemophilus influenzae, Moraxella catarrhalis, Group A streptococcus, and Staphylococcus aureus. The most viral pathogens involved in acute otitis media are rhinovirus, RSV, parainfluenza, coronavirus, and adenovirus. Acute otitis media causes pus to form behind the ear drum. The signs and symptoms of acute otitis media include fussy feelings, being restless or not sleeping well, rubbing the ears or moving the head from side to side, loss of appetite, and fever over 38.3°C.

Figure 01: Acute Otitis Media

Acute otitis media can be diagnosed through health history, physical and ear examination, and imaging tests. Furthermore, acute otitis media is treated through antibiotic therapy (amoxicillin-clavulanate) and analgesic such as a nonsteroidal anti-inflammatory medication or acetaminophen.

What is Chronic Otitis Media?

Chronic otitis media is the inflammation in the middle ear caused by fluid trapped behind the eardrum. It is usually not an infection. However, it can cause infections such as acute otitis media that keep coming back. Chronic otitis media is less painful than acute otitis media. The signs and symptoms are dizziness, ears feeling full, ringing in the ears, ears popping when swallowing or yawning, and turning the volume up on the TV or sitting very close to it.

Figure 02: Chronic Otitis Media

Chronic otitis media can be diagnosed through a review of symptoms and medical history, along with an ear examination. Furthermore, treatment options for chronic otitis media include pain medication, repairing a damaged eardrum and/or hearing bones, removing diseased tissue, and inserting a small tube into the ear to improve ventilation and drainage.

Similarities Between Acute and Chronic Otitis Media

1. Acute and chronic otitis media are two different types of otitis media.
2. Chronic otitis media can lead to acute otitis media.
3. Both can cause hearing impairment.
4. Both can be diagnosed through ear examination.
5. They can be treated through pain medications and supportive therapy.

Difference Between Acute and Chronic Otitis Media

Definition

1. Acute otitis media is a type of otitis media caused either by a bacteria or virus.
2. Chronic otitis media is a type of otitis media caused by trapped fluid trapped behind the eardrum for more than 3 months.

Infection

1. Acute otitis media is an infection.
2. Chronic otitis media is not an infection.

Pain Level

1. Acute otitis media is more painful.
2. Chronic otitis media is less painful.

Signs and Symptoms

1. Signs and symptoms of acute otitis media include drying, irritability, sleeplessness, pulling on the ears, ear pain, headache, neck pain, fluid drainage from the ear, fever, vomiting, lack of balance, and diarrhoea.
2. Signs and symptoms of chronic otitis media include dizziness, feeling full in the ears, ringing sensation in the ears, popping in the ears when people swallow or yawn, and turning the volume up on the TV or sitting very close to it when watching TV.

Treatment

1. Acute otitis media can be treated by giving prescribed antibiotics and analgesics.
2. Chronic otitis media can be treated by giving pain medication, repairing a damaged eardrum and/or hearing bones, removing diseased tissue, and inserting a small tube into the ear to improve ventilation and drainage.

The following table summarizes the difference between acute and chronic otitis media.

Summary – Acute vs Chronic Otitis Media

Otitis media is mainly of two types: acute and chronic otitis media. Acute otitis media is a painful ear infection that results in middle ear inflammation and is caused by a bacteria or a virus, while chronic otitis media is the inflammation in the middle ear that is caused by fluid trapped behind the eardrum. This is the basic difference between acute and chronic otitis media.

FAQ: Acute and Chronic Otitis Media

1. How do people know if the ear is infected or not?

• The common symptoms of an ear infection are pain inside the ear, fever, difficulty hearing, discharge running out of the ear, lethargy, a feeling of pressure inside the ear, itching, and irritation in and around the ear.

2. What causes acute otitis media?

• Acute otitis media occurs when the eustachian tube of children becomes swollen or blocked and traps fluid in the middle ear. This is caused by a bacteria or virus infection. The most common bacterial pathogens in acute otitis media are Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis.

3. How long does acute otitis last?

• Acute otitis media often go away 5 or 3 days, with specific treatment through antibiotic therapy. Often, there may be fluid in the middle ear even after an infection clears up later.

4. How does it treat acute otitis media?

• The main treatment of acute otitis media is antibiotic therapy. The choice for first-line therapy is amoxicillin-clavulanate. Analgesics such as acetaminophen may help in the reduction of pain.

5. How does it treat chronic otitis media?

• Chronic otitis media is generally treated by removing the fluid by surgically placing an ear tube, giving pain medications, repairing a damaged eardrum and/or hearing bones, and removing diseased tissue.

Reference:

1. “Acute otitis media in adults.” UpToDate.
2. “Chronic Otitis Media: Tampa General Hospital.” Chronic Otitis Media | Tampa General Hospital.

Image Courtesy:

1. “Acute Otitis Media Stage of Resolution” By Michael Hawke MD – Own work (CC BY 4.0) via Commons Wikimedia

2. “Otitis chron mesotymp 1” By Welleschik – Own work (CC BY-SA 3.0) via Commons Wikimedia

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